Note: The below are based on broad coverage guidelines but your pharmacy and insurance provider will have more details on your individual coverage options.
Understanding how to access insurance coverage is important, since often medications like this are costly. Let’s explore what insurance coverage and financial support is available.
Before speaking to your healthcare practitioner about your medication, ensure that you speak with your insurance provider to confirm:
- Whether your insurance provider will only cover Wegovy or Ozempic
- If they do cover Wegovy or Ozempic, what are the eligibility requirements
Private Drug Plan Coverage for Ozempic/Wegovy
Your employer’s benefits handbook, or the guidelines package that was assigned to you when you signed up for private insurance should be the first place you start looking for information.
Your coverage options may vary. Some insurers may offer partial coverage for prescription drugs, requiring additional out-of-pocket costs, while others may have a maximum amount the company will cover each year. Some may not have any coverage at all.
If you are unable to find anything relevant in your benefits handbook or guidelines package, you can reach out to your insurer. Before reaching out, here are some valuable pieces of information you should gather that will help save you time when trying to get answers quickly over the phone or through email.
Information that you should have on hand includes:
- Your insurance policy number
- Your personal certificate or identification number
- The medication name you’re looking for
- The medication’s Drug Identification Number (i.e. Ozempic DIN 025, Wegovy DIN 02528509). Each pen has a different Drug Identification Number so ensure you confirm what pen you are using.
In some cases, you may also need to meet a specific medical criteria or provide documentation from your healthcare practitioner in order to be eligible for coverage.
Provincial Health Coverage for Ozempic/Wegovy
Depending on which province you reside in, insurance coverage for Ozempic may vary. In order to be eligible, there may be a specific medical criteria that you need to meet or documentation that you will need to provide from your healthcare practitioner. Wegovy is not currently covered through provincial health care plans.
Learn more about provincial health coverage for Ozempic here.
Novo Nordisk Patient Support Programs
If you’re having trouble determining whether you have insurance coverage for your medication, Novo Nordisk has patient support programs that can help navigate your coverage options.
OzempicCare Patient Support Program
Through the OzempicCare Patient Support Program, you will be able to speak to program educators if you have any questions about your treatment, and guidance to help you navigate and understand your private insurance coverage. Learn more about the OzempicCare Patient Support Program.
WegovyCare Patient Support Program
Similarly, the WegovyCare Patient Support Program provides access to program educators for any questions about your treatment, reimbursement navigators for guidance regarding your private insurance coverage, resources about Wegovy. Learn more about the WegovyCare Patient Support Program.
Learn More About Insurance Coverage for Your Medication:
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